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Navy S Marine Corps Medical News
July 14, 2000
Navy and Marine Corps Medical News (MEDNEWS) is a weekly
compendium of news and information contributed by commands
throughout the Navy medical department . Information contained
in MEDNEWS stories is not necessarily endorsed by Navy Bureau of
Medicine and Surgery (BUMED) , nor should it be considered
official Navy policy.
The BUMED distributes MEDNEWS to Sailors and Marines, their
families, civilian employees and retired Navy and Marine Corps
families . Further distribution is highly encouraged.
Stories in MEDNEWS use these abbreviations after a Navy
medical professional ' s name to show affiliation: MC - Medical
Corps (physician) ; DC - Dental Corps; NC - Nurse Corps; MSC -
Medical Service Corps (clinicians, researchers and
administrative managers) . Hospital Corpsmen (HM) and Dental
Technician (DT) designators are placed in front of their names.
Contents for this week's MEDNEWS:
- Short supply forces anthrax vaccination slowdown
- Navy dental team provides humanitarian assistance
- Hands-on training a plus for the Navy
- Medical Enlisted Commissioning Program board to convene
- Seeking award winning dental reservists
- 'All in the family ' - serving and promoting together
- TRICARE question and answer
- Healthwatch: Dietary Supplements - things to consider
Headline: Short supply forces anthrax vaccination slowdown
By Rudi Williams, American Forces Press Service
WASHINGTON - DoD ' s dwindling supply of anthrax vaccine has
forced a temporary slowdown in inoculations, except to those
personnel serving or about to serve in high-threat areas of
Southwest Asia and South Korea, defense officials said during a
July 11 Pentagon press conference.
Marine Corps Maj. Gen. Randy L. West, senior adviser to the
deputy secretary of defense for chemical and biological
protection, told reporters DoD has only about 160,000 doses of
the vaccine on hand. He said DoD is trying to avoid suspending
or shutting down the anthrax inoculation program.
What ' s left of the vaccine is being largely reserved for
the 10, 000 DoD people "with boots on the ground" in Southwest
Asia and 37, 000 in South Korea, said Dr. J. Jarrett Clinton,
first assistant to the assistant secretary of defense for health
For the time being, most personnel in those areas who have
begun the six-shot series will stop the inoculations if they
rotate out . West said DoD guidance allows for local commanders '
discretion, so, for instance, rotating soldiers might still get
shots because the 10-dose vaccine vials can only be used or
discarded once opened.
So far, 455,378 people have started vaccinations and have
received a total of about 1.8 million shots. Some 56,725 have
received all six shots, West said. During the slowdown, dosing
will fall from about 75, 000 vaccinations monthly to around
14,000. At that rate, DoD has enough vaccine to last up to 10
months, he estimated.
The mandatory six shots provide full protection as required
by the FDA, West noted. He pointed out that receiving fewer than
six shots causes no damage or harm to individuals , but does mean
they lack the additional immunity protection provided by the
Clinton said the first three shots are given in two-week
intervals and the last three, six months apart. An annual
booster shot keeps troops fully protected. Although a person
gains some protection by the second or third shot, it takes the
full six for full, sustained immunity, he said.
Persons who have started the series but not finished will
only need to pick up where they left off once their vaccinations
resume, Clinton said. That's the guidance, he said, of the
Centers for Disease Control ' s expert Advisory Committee for
West attributed the slowdown to the inability of the sole
contractor, Bioport of Lansing, Mich., to gain Food and Drug
Administration approval for its production facility. He said
immunizations will resume at full speed when the FDA approves
and certifies a sufficient supply of vaccine as safe and
effective, but he emphasized Bioport ' s own timetable doesn't
call for its new vaccine to be available before the end of the
"We 're disappointed because we wish we were vaccinating the
whole force now. We're running about a year behind our planned
schedule in this program, " West said.
"When we began the program, there was an existing supply
and there was one company that had a license, " he noted. "In
retrospect, I wish that we would have immediately advertised for
a second source. We did not. We recently have. " BioPort will
cooperate with that second-source contractor, he said, and the
FDA says that company could earn certification in two to four
He said Britain and Russia have anthrax vaccines, but
neither has FDA approval. The British vaccine is similar to the
U.S. vaccine, but also in limited supply, and DoD has no
interest in the Russians ' live-bacteria vaccine, West noted.
He said intelligence reports indicate that the threat has
increased since the anthrax vaccination program started in 1998.
"There has also been an increase in the number of both state
actors and nonstate actors that have done things that have
prompted our intelligence committee to believe they are trying
to obtain the capability (for biological weapons) . "
But, West emphasized, "We 're less at risk than we were in
1998, because we have more than 455, 000 people that have some
protection and 56, 725 are fully protected. But we're less
protected than we want to be. "
Headline: Navy dental team provides humanitarian assistance
By Air Force Capt. Denise N. Shorb U.S. Support Group East Timor
DILI, East Timor - Two dentists and three dental
technicians from 3rd Dental Battalion, Okinawa, Japan, provided
dental services to the people of Dili and surrounding villages
The Dental Civil Action Program team saw more than 400
patients as one of the U.S. rotational presence units conducting
humanitarian assistance projects, coordinated by U.S. Support
Group East Timor (USGET) .
"These people haven't had any kind of dental hygiene care
or educational programs, " said It. Cmdr. Jorge Graziani, DC.
"There' s a general lack of knowledge about how and why you
should care for your teeth. They don't use toothbrushes and
toothpaste, and they chew on nuts that discolor their teeth, "
Accustomed to the conveniences of home, the team had
several obstacles to overcome, including a language barrier. At
one of the clinics they did not have a translator and had to
rely on hand and face gestures .
"People would come in and point to the tooth that hurt
them. It was hard to explain to the patient that sometimes more
teeth than just the one that hurt had to come out, " said
Another problem was with the electricity, or rather the
lack of it . The instruments and equipped had a larger
electrical current than the clinic at Bairo Pite Medical Clinic
could support, so a generator was brought in.
"Even then, we didn't have enough power to work both the
sterilizer and the dental lamps, so we used flashlights instead
of the lamps, " said DTI Paul Johnson.
In Ermera, there was no power available at all, so
instruments were sterilized the old-fashioned way - with boiling
"We've only touched the tip of the needs here in East
Timor, " said Capt. Gary Prose, DC. "We've taken care of an
immediate need on a small part of the population. "
"People need to be made aware of proper dental hygiene, "
said Graziani .
To assist the learning process, the team provided 25 dental
textbooks at the Bairo Pite medical clinic. They also gave
lectures on personal and oral hygiene at the schools in Ermera.
This naval dental team was the second to visit East Timor
with USGET. The first, an Air Force team, came through in
April, and the USS FRANK CABLE (AS 40), a Navy submarine tender,
provided additional dental assistance during their visit here in
Headline: Hands-on trauma training a plus for the Navy
By J02 Michael Howlett, Naval Hospital Bremerton
BREMERTON, Wash. - The medical staff at Naval Hospital
Bremerton is experiencing real life trauma through the
collaboration efforts of the hospital and the largest civilian
trauma center in the Northwest .
Harborview Medical Center, Seattle, has an extensive
outreach education program that hosts people from all over the
region to do training, normally through observation. Since the
military members are federally licensed, they are practicing
vice shadowing the Harborview staff. In an exchange program, NH
Bremerton staff perform training rotations at the medical
"Our goal is to give our people a chance to experience a
steady flow of trauma patients first-hand, " said Cmdr. Dennis
Jepsen, NC, head of emergency department . "It gives us the
chance to train and enhance our skills that we wouldn' t have the
opportunity for here at the hospital. "
This unique program combines civilian and military training
techniques. It opens the door to increasing the effectiveness
of training for Navy service members and helps to avoid cost by
localizing advanced training rather than send service members
cross-country for schools. The program also strengthens
military ties with the local community by working together at
the civilian hospitals .
"Basically, we get the chance to provide continued training
for our people, and Harborview gets some free help, " said Cmdr.
Karen McNamara, NC, head of staff education and training.
The Navy staff has few guidelines and limitations as part
of the exchange. They must review a video explaining
Harborview' s procedure for immobilizing people with suspected
spinal injuries . They are not allowed to provide blood
transfusions to patients, and they aren't expected to do all of
the paperwork involved with patient care.
The Navy staff will work in different areas of Harborview
based on their specialties . In the future, service members will
do rotations in the operating room, intensive care unit, and the
Headline: Medical Enlisted Commissioning Program board to
Applications are being accepted for the FY-01 Medical
Enlisted Commissioning Program (MECP) .
The MECP selection board will convene 11 Dec 00. Submit
applications to Commander, Navy Personnel Command (Pers-811) ,
5720 Integrity Drive Millington, Tenn. 38055-8110, postmarked no
later than October 1, 2000. All supplemental information must
be postmarked no later than November 1, 2000, and must be sent
via the applicant ' s commanding officer.
A waiver of eligibility requirement will be granted for
commissioning age of up to 40 years on a case by case basis. No
other waivers will be considered.
MECP applicants must have applied for admission to a
nationally accredited school of nursing and must include, in
their MECP application, an approved plan of study that
demonstrates they can complete their program in 36 months or
less. Those students who are selected for the MECP must submit
their letters of acceptance to a qualified school of nursing to
the Naval School Of Health Sciences, Code-OE, Bethesda, Md.
20889-5022 no later than March 15, 2001. Applicants no longer
require a letter of acceptance to a nursing school in order to
apply for MECP.
A routine HIV and drug screening within 18 months of
October 1,2000 is required on the SF-88 (report of medical
A list of applications received will be posted on the
BUPERS homepage (www.bupers.navy.mil) under the PERS code icons:
click on PERS-8, 81, in-service procurement branch, and MECP.
For additional information contact Capt . Judy Logeman, NC
or HM2 (FMF) Jeremy Wilkinson at 703-693-2324 .
Headline: Seeking award winning dental reservists
Commander Naval Reserve Force is requesting submissions to
recognize outstanding performance of dental reservists in the
dental community in support of active and reserve components for
the annual Rear Adm. William J. H. Vaughn Memorial Awards.
Naval reserve dental units, naval reserve dental officers
0—5 and below, and naval reserve dental technicians E-6 and
below are eligible to be nominated, provided the individuals and
units were not award recipients within the preceding two years
and three years, respectively .
The submission deadline is October 31, 2000. All commands
are encouraged to submit nominations to COMNAVRESFOR (N01M) ,
4400 Dauphine Street, New Orleans, La 10146.
For additional information call HMCM Victor C. Harshbarger
at (504) 618-1084; DSN 618-1084.
Headline: 'All in the family'- serving and promoting together
By J01 Maria Christina Mercado, NH Pensacola Public Affairs
PENSACOLA, Fla. -It's been said a family that plays
together, stays together. In some cases, they advance together
too. That was the case recently when two generations of the
Navy's medical community were promoted together.
Father, Capt . Graeme Browne, MC, commanding officer of
Fleet Hospital Minneapolis, and son, HM3 Damon Brown assigned to
Naval Hospital Pensacola, were promoted to their current ranks
in a joint ceremony at Naval Pensacola June 23.
"We found out, about the same time, that we had been
promoted. So, we thought it would be fun to do this together, "
said HM3 Browne.
After being promoted to the rank of captain, his wife and
son replaced the shoulder boards on his uniform.
"I am extremely proud of both of them, " said Margaret
Browne, wife and mother. "The opportunity to come here and do
this has been great. It really strengthens the bond between
father and son. "
Capt. Browne f rocked his son after he was promoted. "I had
the pleasure three and a half years ago to enlist my son into
the Navy, and it is with great pride I promote him to petty
officer today, " said Capt. Browne during his son's f rocking
Headline: TRICARE question and answer
Question: How do we obtain emergency care under TRICARE?
And does the copayment increase for the emergency room?
Answer: Any eligible beneficiary should access the nearest
emergency room of any military or civilian hospital for true
emergencies regardless of which TRICARE option you use.
There are no out-of-pocket costs for any care received at a
military hospital, including emergency room care. The out-of-
pocket costs for care received at a civilian emergency room for
families of E-4 and below enrolled in Prime is $10. For
families of E-5 and above and retirees and their families the
copay for an emergency room visit is $30. This single payment,
$10 or $30, includes all emergency room services provided in
conjunction with the visit. For those who have chosen to remain
in TRICARE Standard or use the TRICARE Extra program, their
regular deductibles and copayments apply.
Headline: Healthwatch: Dietary Supplements - things to consider
By LT Mike Prevost, PhD, Aeromedical Safety Officer, Marine
Aircraft Group 39
Camp Pendleton, Calif. - According to the Dietary
Supplement, Health and Education Act (DSHEA) , dietary
supplements are products (other than tobacco) intended to
supplement the diet . They are products that bear or contain one
or more of the following dietary ingredients: a vitamin, a
mineral, an herb or other botanical, an amino acid, a dietary
substance for use by man to supplement the diet by increasing
the total daily intake, or a concentrate, metabolite,
constituent, extract, or combinations of these ingredients. In
addition the product must also be labeled "dietary supplement" .
The intent of the DSHEA was to make a wide variety of safe
and effectively labeled products readily available to consumers.
But according to official definition almost any substance
can be considered a dietary supplement by simply marketing it as
a supplement (if it is not already marketed as a drug) .
Under the DSHEA it is a manufacturer's responsibility to
ensure that its products are safe and properly labeled prior to
The FDA does not approve or disapprove new supplements ,
which allows manufacturers to bypass the extensive studies
required to establish effectiveness and safety prior to the
release of a new drug.
Clinicians, health care providers and health care educators
are presented with a considerable dilemma when providing advice
and guidance on the use of dietary supplements. Even if there
is ample convincing evidence to suggest that a product is
effective and safe, there is no way to guarantee the purity or
accuracy of dose of the product. This makes it difficult to
recommend any product .
It also creates another dilemma. If the health care system
takes a negative view of dietary supplements, the patient may
dismiss the health care system as a valuable source of
information on dietary supplements . Instead they may choose
more biased, misleading or inaccurate sources of information.
It is difficult for health care professionals to compete against
slick advertisements promising very attractive benefits.
The problem is compounded by the fact that the "quick fix"
promised by supplement manufacturers is often much more
attractive than the alternatives provided by health care
professionals (i.e. exercise, diet, surgery, medications,
lifestyle modifications) .
Health care professionals must be willing to talk to
patients about dietary supplements so they will not seek out
alternate sources to gather information, which may be biased,
misleading and inaccurate.
A proactive approach will be more successful than a
reactive approach. Discussing the effectiveness and safety of
some of the more popular products pertaining to the patients '
particular situation, for example obesity and weight loss. The
health care professional might also discuss common advertising
gimmicks and perhaps point out some examples of misleading
advertisements so that the patient is made fully aware of
There are four major negative consequences that health care
professionals should consider before providing guidance or
advice on the use of dietary supplements:
- Almost any substance can be marketed as a dietary supplement .
- The FDA does not test dietary supplements for safety prior to
- The FDA does not routinely test dietary supplements for purity
or accuracy of dose prior to sale.
- Manufacturers can make nutritional support claims without
substantial scientific evidence.
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